Brenda V Maldonado Yanez, Kendall E Ferrara, Richard Lueking, Taylor Morrisette, Erin E Brewer, Nicole H Lewis, Rachel Burgoon, Krutika Mediwala Hornback, Aaron C Hamby
{"title":"比较系统远程抗菌药物管理计划对社区医院将静脉注射抗菌药物转为口服抗菌药物的影响。","authors":"Brenda V Maldonado Yanez, Kendall E Ferrara, Richard Lueking, Taylor Morrisette, Erin E Brewer, Nicole H Lewis, Rachel Burgoon, Krutika Mediwala Hornback, Aaron C Hamby","doi":"10.1017/ash.2024.423","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Evaluate system-wide antimicrobial stewardship program (ASP) update impact on intravenous (IV)-to-oral (PO) antimicrobial conversion in select community hospitals through pre- and postimplementation trend analysis.</p><p><strong>Methods: </strong>Retrospective study across seven hospitals: region one (four hospitals, 827 beds) with tele-ASP managed by infectious diseases (ID)-trained pharmacists and region two (three hospitals, 498 beds) without. Data were collected pre- (April 2022-September 2022) and postimplementation (April 2023-September 2023) on nine antimicrobials for the IV to PO days of therapy (DOTs). Antimicrobial administration route and (DOTs)/1,000 patient days were extracted from the electronical medical record (EMR). Primary outcome: reduction in IV DOTs/1,000 patient days. Secondary outcomes: decrease in IV usage via PO:total antimicrobial ratios and cost reduction.</p><p><strong>Results: </strong>In region one, IV usage decreased from 461 to 209/1,000 patient days (<i>P</i> = < .001), while PO usage increased from 289 to 412/1,000 patient days (<i>P</i> = < .001). Total antimicrobial use decreased from 750 to 621/1,000 patient days (<i>P</i> = < .001). In region two, IV usage decreased from 300 to 243/1,000 patient days (<i>P</i> = .005), and PO usage rose from 154 to 198/1,000 patient days (<i>P</i> = .031). The PO:total antimicrobial ratios increased in both regions, from .42-.52 to .60-.70 in region one and from .36-.55 to .46-.55 in region two. IV cost savings amounted to $19,359.77 in region one and $4,038.51 in region two.</p><p><strong>Conclusion: </strong>The ASP intervention improved IV-to-PO conversion rates in both regions, highlighting the contribution of ID-trained pharmacists in enhancing ASP initiatives in region one and suggesting tele-ASP expansion may be beneficial in resource-constrained settings.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450665/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of the impact of a system tele-antimicrobial stewardship program on the conversion of intravenous-to-oral antimicrobials in community hospitals.\",\"authors\":\"Brenda V Maldonado Yanez, Kendall E Ferrara, Richard Lueking, Taylor Morrisette, Erin E Brewer, Nicole H Lewis, Rachel Burgoon, Krutika Mediwala Hornback, Aaron C Hamby\",\"doi\":\"10.1017/ash.2024.423\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Evaluate system-wide antimicrobial stewardship program (ASP) update impact on intravenous (IV)-to-oral (PO) antimicrobial conversion in select community hospitals through pre- and postimplementation trend analysis.</p><p><strong>Methods: </strong>Retrospective study across seven hospitals: region one (four hospitals, 827 beds) with tele-ASP managed by infectious diseases (ID)-trained pharmacists and region two (three hospitals, 498 beds) without. Data were collected pre- (April 2022-September 2022) and postimplementation (April 2023-September 2023) on nine antimicrobials for the IV to PO days of therapy (DOTs). Antimicrobial administration route and (DOTs)/1,000 patient days were extracted from the electronical medical record (EMR). Primary outcome: reduction in IV DOTs/1,000 patient days. Secondary outcomes: decrease in IV usage via PO:total antimicrobial ratios and cost reduction.</p><p><strong>Results: </strong>In region one, IV usage decreased from 461 to 209/1,000 patient days (<i>P</i> = < .001), while PO usage increased from 289 to 412/1,000 patient days (<i>P</i> = < .001). Total antimicrobial use decreased from 750 to 621/1,000 patient days (<i>P</i> = < .001). In region two, IV usage decreased from 300 to 243/1,000 patient days (<i>P</i> = .005), and PO usage rose from 154 to 198/1,000 patient days (<i>P</i> = .031). The PO:total antimicrobial ratios increased in both regions, from .42-.52 to .60-.70 in region one and from .36-.55 to .46-.55 in region two. IV cost savings amounted to $19,359.77 in region one and $4,038.51 in region two.</p><p><strong>Conclusion: </strong>The ASP intervention improved IV-to-PO conversion rates in both regions, highlighting the contribution of ID-trained pharmacists in enhancing ASP initiatives in region one and suggesting tele-ASP expansion may be beneficial in resource-constrained settings.</p>\",\"PeriodicalId\":72246,\"journal\":{\"name\":\"Antimicrobial stewardship & healthcare epidemiology : ASHE\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450665/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Antimicrobial stewardship & healthcare epidemiology : ASHE\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1017/ash.2024.423\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Antimicrobial stewardship & healthcare epidemiology : ASHE","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1017/ash.2024.423","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Comparison of the impact of a system tele-antimicrobial stewardship program on the conversion of intravenous-to-oral antimicrobials in community hospitals.
Objectives: Evaluate system-wide antimicrobial stewardship program (ASP) update impact on intravenous (IV)-to-oral (PO) antimicrobial conversion in select community hospitals through pre- and postimplementation trend analysis.
Methods: Retrospective study across seven hospitals: region one (four hospitals, 827 beds) with tele-ASP managed by infectious diseases (ID)-trained pharmacists and region two (three hospitals, 498 beds) without. Data were collected pre- (April 2022-September 2022) and postimplementation (April 2023-September 2023) on nine antimicrobials for the IV to PO days of therapy (DOTs). Antimicrobial administration route and (DOTs)/1,000 patient days were extracted from the electronical medical record (EMR). Primary outcome: reduction in IV DOTs/1,000 patient days. Secondary outcomes: decrease in IV usage via PO:total antimicrobial ratios and cost reduction.
Results: In region one, IV usage decreased from 461 to 209/1,000 patient days (P = < .001), while PO usage increased from 289 to 412/1,000 patient days (P = < .001). Total antimicrobial use decreased from 750 to 621/1,000 patient days (P = < .001). In region two, IV usage decreased from 300 to 243/1,000 patient days (P = .005), and PO usage rose from 154 to 198/1,000 patient days (P = .031). The PO:total antimicrobial ratios increased in both regions, from .42-.52 to .60-.70 in region one and from .36-.55 to .46-.55 in region two. IV cost savings amounted to $19,359.77 in region one and $4,038.51 in region two.
Conclusion: The ASP intervention improved IV-to-PO conversion rates in both regions, highlighting the contribution of ID-trained pharmacists in enhancing ASP initiatives in region one and suggesting tele-ASP expansion may be beneficial in resource-constrained settings.